European Journal of Cardiovascular Medicine

Background:  Tympanoplasty1 is a surgical procedure to eradicate the disease in the middle ear and to reconstruct the hearing mechanism with or without tympanic membrane grafting. While Myringoplasty3 is a surgical procedure in which the reconstructive procedure is limited to repair of tympanic membrane perforation assuming that middle ear ossicles are functioning normally, eustachian tube is patent, and the patient has a good cochlear reserve. Objectives: 1. To evaluate pre and postoperative audiological status in Type I Tympanoplasty. 2. To evaluate the audiological outcome by using different graft materials 3. To study the effect of time taken for graft uptake on the audiological outcome. 4. To study the effect of Valsalva maneuver on the audiological outcome. Material & Methods: Study Design: Prospective Hospital based observational study. Study area: Department of E.N.T, Narayana Medical College and Hospital, Nellore, Andhra Pradesh. Study Period: October 2021 – March 2022.   Study population:  Patients with CSOM tubo tympanic disease who underwent Type 1 tympanoplasty by underlay technique in the Department of ENT. Sample size: study consisted a total of 60 cases. Sampling method: Simple random method. Study tools and Data collection procedure: All the patients who presented with symptoms and signs suggesting tubotympanic type CSOM were submitted to an assessment protocol, based on a guided history taking, specific physical exam (otoscopy), and subjected to audiogram. During history taking, the patients were questioned about disease onset, and if they had undergone previous otologic surgeries. A detailed proforma was filled for each patient with regard to history, clinical examination, investigations, surgical procedures, postoperative period &follow up visits. Audiological evaluation (pure tone audiometry) done preoperatively, 3 months & 6 months after surgery and the results were tabulated. Results: The audiological improvement (average audiological gain) is more with temporalis fascia (11.4 dB) when compared to tragal perichondrium (9.71 dB) and tragal perichondrium with cartilage graft (8.62 dB). Audiological benefit was found to correlate with the time taken for graft take up, as the time taken for graft uptake increases, the hearing gain was found to decrease post operatively. Conclusion: In this series considerable improvement has been achieved in hearing in majority of cases (93.34%). Audiological outcomes are better for temporalis fascia followed by tragal perichondrium and tragal perichondrium with cartilage. Incorporation of valsalva maneuver may add some benefit postoperatively on surgical outcome. Type of surgical approach has no influence on audiological outcome in the present study.